Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease

Background-The course of Crohn's disease is characterised by the occurrence of intestinal complications such as strictures, intra-abdominal fistulas, or abscesses. Standard diagnostic procedures may fail to show these complic ations, in particular fistulas. Aims-To test the value of transabdominal bowel sonography (TABS) for the de tection of intestinal complications in Crohn's disease. Methods-TABS was prospectively performed in 213 patients with Crohn's disea se in a university based inflammatory bowel disease referral centre. Thirty three underwent resective bowel surgery and were included in this study. T he accuracy of TABS to detect strictures, intraabdominal fistulas, or absce sses was compared with surgical and pathological findings. Results-TABS was able to identify strictures in 22/22 patients and to exclu de it in 10/11 patients (100% sensitivity, 91% specificity). Fistulas were correctly identified in 20/23 patients and excluded in 9/10 patients (87% s ensitivity, 90% specificity). Intra-abdominal abscesses were correctly dete cted in 9/9 patients and excluded in 22/24 patients (100% sensitivity, 92% specificity). Conclusions-In experienced hands TABS is an accurate method for the detecti on of intestinal complications in Crohn's disease. TABS is thus recommended as a primary investigative method for evaluation of severe Crohn's disease .